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The role of job strain on return to work after carpal tunnel surgery.

Authors
Gimeno-D; Amick-BC; Habeck-RV; Ossmann-J; Katz-JN
Source
Occup Environ Med 2005 Nov; 62(11):778-785
NIOSHTIC No.
20028821
Abstract
To examine the impact of job strain (that is, high psychological job demands and low job control) on return to work and work role functioning at two months, six months, or both, following carpal tunnel release surgery. A community based cohort of carpal tunnel syndrome (CTS) patients from physician practices was recruited between April 1997 and October 1998 throughout Maine (USA). 128 patients at two months and 122 at six months completed all relevant questions. A three level outcome variable indicated whether patients had: (1) returned to work functioning successfully, (2) returned to work functioning with limitations, or (3) not returned to work for health reasons. Two job strain measures were created: one, by combining psychological job demands and job control; and two, by dividing demands by control. Ordinal logistic regression was used to identify predictors of the three level work outcome variable. After adjustment, workers with high demands and high control (active work) were less likely to successfully return to work (OR = 0.22; p = 0.014) at two months. Having a job with higher demands than job control (high strain) predicted not returning to work or returning to work but not successfully meeting job demands (OR = 0.14; p = 0.001), at six months. The findings underscore the role of psychosocial work conditions, as defined by the Karasek demand-control model, in explaining a worker's return to work. Clinicians, researchers, and employers should consider a multidimensional and integrative model of successful work role functioning upon return to work. Moreover, since the evidence of the effects of work process changes on the reduction of CTS is very scarce, these findings point to the opportunity for collaborative workplace interventions to facilitate successful return to work.
Keywords
Carpal-tunnel-syndrome; Surgery; Workers; Worker-health; Psychological-factors; Work-environment; Work-practices; Questionnaires; Work-capability; Work-analysis; Disabled-workers
Contact
Dr D Gimeno , Southwest Center for Occupational and Environmental Health, The University of Texas School of Public Health, Health Science Center at Houston, 1200 Herman Pressler Street, RAS W1004D, PO Box 20186, Houston, Texas 77225-0186 USA
CODEN
OEMEEM
Publication Date
20051101
Document Type
Journal Article
Email Address
David.Gimeno.1@uth.tmc.edu
Funding Amount
667241
Funding Type
Grant
Fiscal Year
2006
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R01-OH-003523
Issue of Publication
11
ISSN
1351-0711
Priority Area
Work Environment and Workforce: Organization of Work
Source Name
Occupational and Environmental Medicine
State
TX
Performing Organization
University of Texas, School of Public Health, Houston Health Science Center, Houston, Texas
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